Determinants of mortality in a large group of hemodialysis patients hospitalized for COVID-19
| Autor: | Ali Riza Odabas, Tuba Elif Ozler, Savas Ozturk, Ozkan Gungor, Yavuz Ayar, Ebru Gok Oguz, Bulent Tokgoz, Kenan Turgutalp, Mahmut Islam, Ilay Berke Mentes, Halil Zeki Tonbul, Rumeyza Kazancioglu, Ender Hur, Zeki Aydin, Bulent Demirelli, Erkan Sengul, Mustafa Arici, Numan Gorgulu, Tamer Sakaci, Bülent Huddam, Alaattin Yildiz, Kenan Ates, Mehmet Riza Altiparmak, Savas Sipahi, Necmi Eren, Siren Sezer, Sami Uzun |
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| Přispěvatelé: | İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Altiparmak, Mehmet Riza, KAZANCIOĞLU, Rümeyza |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Critical Care Turkey medicine.medical_treatment Clinical findings Radiological manifestations lcsh:RC870-923 law.invention Pulmonary Disease Chronic Obstructive law Renal Dialysis Risk Factors Intensive care Internal medicine medicine Humans Hemodialysis COVID-19 Mortality Hospital Mortality Pandemics Survival analysis Aged Retrospective Studies Mechanical ventilation Heart Failure business.industry SARS-CoV-2 Mortality rate Retrospective cohort study Middle Aged medicine.disease lcsh:Diseases of the genitourinary system. Urology Intensive care unit Respiration Artificial Hospitalization Radiography Nephrology Heart failure Kidney Failure Chronic Female business Research Article |
| Zdroj: | BMC Nephrology BMC Nephrology, Vol 22, Iss 1, Pp 1-10 (2021) |
| Popis: | Background Maintenance hemodialysis (MHD) patients are at increased risk for coronavirus disease 2019 (COVID-19). The aim of this study was to describe clinical, laboratory, and radiologic characteristics and determinants of mortality in a large group of MHD patients hospitalized for COVID-19. Methods This multicenter, retrospective, observational study collected data from 47 nephrology clinics in Turkey. Baseline clinical, laboratory and radiological characteristics, and COVID-19 treatments during hospitalization, need for intensive care and mechanical ventilation were recorded. The main study outcome was in-hospital mortality and the determinants were analyzed by Cox regression survival analysis. Results Of 567 MHD patients, 93 (16.3%) patients died, 134 (23.6%) patients admitted to intensive care unit (ICU) and 91 of the ones in ICU (67.9%) needed mechanical ventilation. Patients who died were older (median age, 66 [57–74] vs. 63 [52–71] years, p = 0.019), had more congestive heart failure (34.9% versus 20.7%, p = 0.004) and chronic obstructive pulmonary disease (23.6% versus 12.7%, p = 0.008) compared to the discharged patients. Most patients (89.6%) had radiological manifestations compatible with COVID-19 pulmonary involvement. Median platelet (166 × 103 per mm3 versus 192 × 103 per mm3, p = 0.011) and lymphocyte (800 per mm3 versus 1000 per mm3, p p = 0.001) on admission were lower in patients who died. Age (HR: 1.022 [95% CI, 1.003–1.041], p = 0.025), severe-critical disease clinical presentation at the time of diagnosis (HR: 6.223 [95% CI, 2.168–17.863], p p = 0.009), ferritin levels on admission (HR; 1.057 [95% CI, 1.006–1.111], p = 0.028), elevation of aspartate aminotransferase (AST) (HR; 3.909 [95% CI, 2.143–7.132], p 3 per mm3) during hospitalization (HR; 1.864 [95% CI, 1.025–3.390], p = 0.041) were risk factors for mortality. Conclusion Hospitalized MHD patients with COVID-19 had a high mortality rate. Older age, presence of heart failure, clinical severity of the disease at presentation, ferritin level on admission, decrease in platelet count and increase in AST level during hospitalization may be used to predict the mortality risk of these patients. |
| Databáze: | OpenAIRE |
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